PNEUMOTHORAX

General Information

DEFINITION--Collapse of part or all of a lung caused by pressure from free air in the chest between the two layers of the pleura (thin membranes that cover the lung). The pain is sometimes confused with a heart attack.

BODY PARTS INVOLVED--Lung; pleura.

SEX OR AGE MOST AFFECTED--All ages, but most common in active young men (20 to 40 years).

SIGNS & SYMPTOMS--

The following symptoms vary according to the degree of lung collapse and extent of underlying lung disease. Symptoms may be less acute if the pneumothorax develops slowly:

• Sharp chest pain. Pain may extend to a shoulder or across the chest or abdomen.
• Shortness of breath.
• Dry, hacking cough (occasionally).

CAUSES

Spontaneous pneumothorax:

• Rupture of a small air sac in the lung resulting from asthma, lung abscess or empyema, or physical exertion, such as diving, high-altitude flying or stretching. Causes related to activity occur most often in healthy persons.

Pneumothorax due to trauma:

• Penetrating wounds to the chest, which permit outside air to rush into the pleural space and cause the lung to collapse.
• Complication of removing fluid from the lung (thoracentesis).

RISK INCREASES WITH

• Chest injury.
• Chronic lung disease.
• Smoking.
• Exercise, stretching.
• Diving.
• High altitude flying.
• Cancer.

HOW TO PREVENT

• Obtain medical treatment for lung disorders, such as asthma or emphysema.
• Don't smoke.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-rays of the chest to confirm the diagnosis and determine the size of the pneumothorax.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Treatment depends on the size of the pneumothorax and the condition of the lungs. The disorder may heal itself, but hospitalization and treatment may be necessary to remove the air.

POSSIBLE COMPLICATIONS

• Pulmonary edema.
• Lung infection.
• Repeated pneumothorax requiring surgery.

PROBABLE OUTCOME--A small pneumothorax is inconsequential and heals itself. However, if the collapse is extensive and it occurs in middle-aged or older adults whose lungs are damaged by asthma, chronic bronchitis or emphysema, it can lead to respiratory failure and critical illness.

How To Treat

GENERAL MEASURES--

• Don't smoke; try not to cough; avoid loud talking, laughing or singing.
• You may be more comfortable if you rest in a sitting position.
• If at home, monitor your blood pressure, pulse rate and respirations.

MEDICATION--Medication usually is not necessary. However, you may use non-prescription drugs, such as acetaminophen, for minor pain. For severe pain, your doctor may prescribe stronger pain relievers.

ACTIVITY--Stay as active as your strength allows. Rest often. Resume your normal activities as soon as possible. Allow about 2 weeks for recovery.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of pneumothorax.
• The following occurs during treatment: Temperature rises to 101F (38.3C). Chest pain or shortness of breath increases. Painful, debilitating coughing or sputum production begins.